Request for Baptism Certificate

Request for Baptism Certificate

Please use this form to request a copy of a Baptismal Certificate. Provide any information on the BAPTIZED PERSON you have to assist us in finding the requested record. (An individual must have been baptized at Our Lady of Lourdes Church for a certificate to be prepared. We do not prepare baptism certificates for other parishes. Copies of Baptismal Certificates are only provided by the Church of Baptism, even if you received other sacraments in other parishes.)
Name

First NameMiddle NameLast Name
Baptized Person's Date of Birth

MonthDayYear
Date
Approximate Date of Baptism (if known)
Baptized Person's Father's Name

First NameLast Name
Baptized Person Mother's MAIDEN name

First NameLast Name
How would the Baptized Person Wish to Receive the Certificate
Address where Certificate can be sent (if not picked up)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Baptized Person (incase we need to contact)
Please enter a valid phone number.Format: (000) 000-0000.
Email of person requesting Certifcate
example@example.com
Your voluntary $10 donation to Our Lady of Lourdes will help defray costs of processing and sending your certificate. We thank you for your kindness in supporting the work and ministry of Our Lady of Lourdes.

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